Ruhong Wu, Jia Shi, Jiachao Cao, Yumin Mao and Bo Dong *
|
|
- Ruby Parsons
- 5 years ago
- Views:
Transcription
1 Wu et al. BMC Surgery (2017) 17:123 DOI /s CASE REPORT Open Access Two occurrences of delayed epidural hematoma in different areas following decompressive craniectomy for acute subdural hematoma in a single patient: a case report Ruhong Wu, Jia Shi, Jiachao Cao, Yumin Mao and Bo Dong * Abstract Background: Delayed epidural hematoma (DEH) following evacuation of traumatic acute subdural hematoma (ASDH) or acute epidural hematoma (EDH) is a rare but devastating complication, especially when it occurs sequentially in a single patient. Case presentation: A 19-year-old man who developed contralateral DEH following craniotomy for evacuation of a traumatic right-side ASDH and then developed a left-side DEH of the posterior cranial fossa after craniotomy for evacuation of the contralateral DEH. He was immediately returned to the operating room for additional surgeries and his neurological outcome was satisfactory. Conclusions: Although DEH occurring after evacuation of ASDH or acute EDH is a rare event, timely recognition is critical to prognosis. Keywords: Acute subdural hematoma, Acute epidural hematoma, Delayed epidural hematoma, Decompressive craniectomy, Computed tomography Background Although delayed epidural hematoma (DEH) is an uncommon complication following evacuation of intracranial hematomas, it is devastating nevertheless, especially following the evacuation of traumatic acute subdural hematoma (ASDH). A previous study reported the incidence of delayed postoperative epidural hematoma (EDH) to be 1.0% [1]. A total of 38 cases of such DEH were found in literature (Table 1). We report a case involving a Chinese man who developed contralateral DEH following decompressive surgery for right-side ASDH, and then developed an additional remote DEH following decompressive surgery for the contralateral DEH. * Correspondence: @qq.com Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou City , China Case presentation A 19-year-old Chinese man involved in a motor vehicle accident was admitted to the emergency department presenting with a Glasgow Coma Scale (GCS) of 3 and right eye mydriasis. A computed tomography (CT) scan of his brain revealed right-side ASDH and a midline shift of 14.5 mm with severe brain swelling (Figs. 1 and 3). He was hemodynamically stable, with no clotting dysfunction according laboratory tests. He was subsequently transferred to the operating room and underwent a right decompressive craniectomy. The ASDH was caused by a ruptured lateral fissure vein. The brain exhibited slowly progressing swelling after the hematoma and inactivated brain tissue were evacuated. Consequently, immediate augmentation duraplasty using artificial dura mater was performed. On examination, the patient exhibited bilateral mydriasis. Given the slowly progressing brain swelling, this was possibly due to delayed contralateral ASDH or The Author(s) Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
2 Wu et al. BMC Surgery (2017) 17:123 Page 2 of 5 Table 1 Cases of DEH, found in literature Authors Age/Sex GCS GOS 1 Xu et al. [16] 10/F Meguins et al. [15] 39/M Nadig et al. [17] 21/M Shen et al. [18] 51/M /M /M /M /F Saberi et al. [5] 19/M Su et al. [9] 39/M /M /F /F /M /M /M /F /M /M /F /F Mohindra et al. [11] 45/M /M Boviatsis et al. [13] 49/M Cohen et al. [19] 76/F Matsuno et al. [20] 17/M /M /M /M Feuerman et al. [21] 29/F /M /F Meguro et al. [22] 22/M /F Borovich et al. [23] 39/M Piepmeier et al. [24] 39/M /M /M 6 2 GCS Glasgow Coma Scale, GOS Glasgow Outcome Scale EDH. A CT scan of the brain was performed immediately thereafter, which revealed the emergence of contralateral DEH (Fig. 2). Owing to a mass effect from the DEH and severe brain swelling, the patient was immediately taken to the operating room to undergo a left hematoma evacuation and decompressive craniectomy. During surgery, it was determined that the DEH was caused by the rupture of the middle meningeal artery branch, with temporal and occipital bone fractures (Fig. 3a). Following surgery, the patient was transferred to the neurological intensive care unit, where the left and right pupil sizes were measured to be 2.0 mm and 5.0 mm, respectively. On postoperative day 1, approximately 5 h after the second surgery, the primary nurse found that the size of the patient s left pupil gradually increased from 2.0 mm to 3.5 mm. An immediate brain CT scan revealed evidence of left-side DEH of the posterior cranial fossa (Fig. 4). Owing to mass effect of the DEH, a third surgery was offered. He underwent left posterior cranial fossa hematoma evacuation and decompressive craniectomy. During the third surgery, it was determined that the DEH was caused by a ruptured transverse sinus. A brain CT following the third surgery was performed (Fig. 5). The patient recovered to a GCS of 7 within 40 days after surgery, and was transferred to the rehabilitation hospital. He was ultimately discharged from the rehabilitation hospital with a Glasgow Outcome Score of 4. He underwent cranioplasty 1 year later and has since recovered well. Discussion and conclusion Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in adults in highly developed countries, with the highest incidence in men aged years [2]. Approximately one-third of patients with severe TBI are diagnosed with ASDH [3]. According to the guidelines for severe TBIs, ASDH causing brain herniation should be immediately evacuated with or without bone flap removal and duraplasty [4]. DEH following decompressive surgery for ASDH or acute EDH is an extremely uncommon occurrence, with only dozens of cases in the medical literature published in English (Table 1); nevertheless, it is a devastating complication [5 8]. To our knowledge, our report is the first to document two occurrences of DEH in different Fig. 1 Admission computed tomography showing right acute subdural hematoma with midline shift
3 Wu et al. BMC Surgery (2017) 17:123 Page 3 of 5 Fig. 2 Computed tomography following the first decompressive surgery showing contralateral delayed epidural hematoma a b Fig. 3 a The Axial Bone window showing a left temporal bone fractures. b The Axial Bone window showing left occipital intracranial pneumatocele Fig. 4 Computed tomography following the second decompressive surgery showing remote delayed epidural hematoma Fig. 5 Computed tomography following the third decompressive surgery
4 Wu et al. BMC Surgery (2017) 17:123 Page 4 of 5 areas following decompressive craniectomy for traumatic ASDH in a single patient, who developed DEH sequentially following decompressive surgery for ASDH and DEH. There were some signs that alerted us to the possibility of DEH following evacuation of the ASDH or acute EDH, including a skull fracture, intraoperative brain swelling, pupillary dilation, an unmanageable elevated intracranial pressure (ICP) [9], a large volume of intraoperative blood loss, long duration of craniotomy, and a large craniotomy area [10]. During the first surgery in this case, the brain exhibited slowly progressing swelling, with bilateral mydriasis after the hematoma and inactivated brain tissue were evacuated. A subsequent CT scan revealed a large contralateral DEH. On postoperative day 1 after the second surgery, the size of the patient s left pupil gradually increased from 2.0 mm to 3.5 mm, with a CT scan revealing a large posterior fossa DEH. When these alarm signs presented, we need an immediate brain CT scan to exclude remote DEH. There are many explanations for the pathogenesis of DEH following evacuation of ASDH or acute EDH, including loss of tamponade effect, abnormal vasomotor mechanisms, and acute coagulopathy [11]. The main cause, however, appears to be a disruption of the equilibrium in damaged vessels and reactive intracranial hypertension [12]. Sources of bleeding include a ruptured meningeal arterial branch or a skull fracture [13, 14]. We believe that the primary mechanism of DEH in this case was the loss of the tamponadeeffectwiththeruptureofthemeningealarterial branch and transverse sinus, and skull fractures. Thus, if there is a possibility of remote DEH after surgery, a CT scan of the brain is necessary. In this case, the brain exhibited slowly progressive swelling during the first surgery with the left temporal and occipital bone fractures, a postoperative brain CT would been taken immediately to exclude the possibility of delayed hematoma; meanwhile, the patient sfamily were struggling financially, and the imported ICP monitor was cost prohibitive. Consequently, an ICP monitor was not implanted. But if it was feasible, implantation of a continuous ICP monitor during the first surgery would have helped us to recognize the DEH in a timely manner [15]. This case suggests that DEH following craniotomy for evacuation of traumatic ASDH or acute EDH should always be considered a possibility, especially in cases of intra-operative brain swelling and skull fractures, even though CT may provide no evidence of remote skull fractures. Cautious observation and early postoperative radiological evaluation may facilitate timely recognition of these remote DEHs and contribute to improved patient outcomes. Abbreviations ASDH: Acute subdural hematoma; CT: Computed tomography; DEH: Delayed epidural hematoma; EDH: Epidural hematoma; GCS: Glasgow coma scale; GOS: Glasgow outcome scale; ICP: intracranial pressure; TBI: Traumatic brain injury Acknowledgements Not applicable. Funding No funding. Availability of data and materials All patient data and clinical approaches adopted are contained in the medical files of The Third Affiliated Hospital of Soochow University. The bibliographic data of reference are available on PubMed and the conclusions are based on the opinion of the expert involved in this case. The data supporting the conclusions of this article are included within the article and its figures. Authors contributions All authors participated in the management of the patient in this case report. JS and JC collected patient data. RW performed literature review and drafted the manuscript. BD and YM revised the paper and gave the final approval of the definitive version of the article. All authors read and approved the manuscript. Ethics approval and consent to participate Not applicable. Consent for publication Written informed consent was obtained from the patient s father for publication of this Case Report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal. Competing interests The authors declare that they have no competing interests. Publisher s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Received: 24 March 2017 Accepted: 9 November 2017 References 1. Fukamachi A, Koizumi H, Nagaseki Y, Nukui H. Postoperative extradural hematomas: computed tomographic survey of 1105 intracranial operations. Neurosurgery. 1986;19(4): Shumskaya E, Andriessen TM, Norris DG, Vos PE. Abnormal whole-brain functional networks in homogeneous acute mild traumatic brain injury. Neurology. 2012;79(2): Vilcinis R, Bunevicius A, Tamasauskas A. The association of surgical method with outcomes of acute subdural hematoma patients: experience with 643 consecutive patients. World Neurosurg. 2017; 4. Carney N, Totten AM, O'Reilly C, Ullman JS, Hawryluk GW, Bell MJ, Bratton SL, Chesnut R, Harris OA, Kissoon N, et al. Guidelines for the Management of Severe Traumatic Brain Injury, fourth edition. Neurosurgery. 2016; 5. Saberi H, Meybodi AT, Meybodi KT, Habibi Z, Mirsadeghi SM. Delayed postoperative contralateral epidural hematoma in a patient with right-sided acute subdural hematoma: a case report. Cases J. 2009;2: Tomycz ND, Germanwala AV, Walter KA. Contralateral acute subdural hematoma after surgical evacuation of acute subdural hematoma. J Trauma. 2010;68(1):E Takeuchi S, Takasato Y. Contralateral acute subdural hematoma after surgical evacuation of the initial hematoma: two case reports and review of the literature. Turk Neurosurg. 2013;23(2): Solomiichuk VO, Drizhdov KI. Contralateral delayed epidural hematoma following intracerebral hematoma surgery. Surg Neurol Int. 2013;4: TM S, Lee TH, Chen WF, Lee TC, Cheng CH. Contralateral acute epidural hematoma after decompressive surgery of acute subdural hematoma: clinical features and outcome. J Trauma. 2008;65(6): Kim SH, Lee JH, Joo W, Chough CK, Park HK, Lee KJ, Rha HK. Analysis of the risk factors for development of post-operative extradural hematoma after intracranial surgery. Br J Neurosurg. 2015;29(2): Mohindra S, Mukherjee KK, Gupta R, Chhabra R, Gupta SK, Khosla VK. Decompressive surgery for acute subdural haematoma leading to
5 Wu et al. BMC Surgery (2017) 17:123 Page 5 of 5 contralateral extradural haematoma: a report of two cases and review of literature. Br J Neurosurg. 2005;19(6): Lesoin F, Viaud C, Pruvo J, Redford H, Jomin M. Traumatic and alternating delayed intracranial hematomas. Neuroradiology. 1984;26(6): Boviatsis EJ, Korfias S, Kouyialis AT, Sakas DE. Epidural haematoma after evacuation of contralateral subdural haematoma. Ir J Med Sci. 2004; 173(4): Talbott JF, Gean A, Yuh EL, Stiver SI. Calvarial fracture patterns on CT imaging predict risk of a delayed epidural hematoma following decompressive craniectomy for traumatic brain injury. AJNR Am J Neuroradiol. 2014;35(10): Meguins LC, Sampaio GB, Abib EC, Adry RA, Ellakkis RF, Ribeiro FW, Maset AL, de Morais DF. Contralateral extradural hematoma following decompressive craniectomy for acute subdural hematoma (the value of intracranial pressure monitoring): a case report. J Med Case Rep. 2014;8: GZ X, Wang MD, Liu KG, Bai YA. A rare remote epidural hematoma secondary to decompressive craniectomy. J Craniofac Surg. 2014;25(1): e Nadig AS, King AT. Traumatic extradural haematoma revealed after contralateral decompressive craniectomy. Br J Neurosurg. 2012;26(6): Shen J, Pan JW, Fan ZX, Zhou YQ, Chen Z, Zhan RY. Surgery for contralateral acute epidural hematoma following acute subdural hematoma evacuation: five new cases and a short literature review. Acta Neurochir. 2013;155(2): Cohen JE, Rajz G, Itshayek E, Umansky F. Bilateral acute epidural hematoma after evacuation of acute subdural hematoma: brain shift and the dynamics of extraaxial collections. Neurol Res. 2004;26(7): Matsuno A, Katayama H, Wada H, Morikawa K, Tanaka K, Tanaka H, Murakami M, Fuke N, Nagashima T. Significance of consecutive bilateral surgeries for patients with acute subdural hematoma who develop contralateral acute epi- or subdural hematoma. Surg Neurol. 2003;60(1): discussion Feuerman T, Wackym PA, Gade GF, Lanman T, Becker D. Intraoperative development of contralateral epidural hematoma during evacuation of traumatic extraaxial hematoma. Neurosurgery. 1988;23(4): Meguro K, Kobayashi E, Maki Y. Acute brain swelling during evacuation of subdural hematoma caused by delayed contralateral extradural hematoma: report of two cases. Neurosurgery. 1987;20(2): Borovich B, Braun J, Guilburd JN, Zaaroor M, Michich M, Levy L, Lemberger A, Grushkiewicz I, Feinsod M, Schachter I. Delayed onset of traumatic extradural hematoma. J Neurosurg. 1985;63(1): Piepmeier JM, Wagner FC Jr. Delayed post-traumatic extracerebral hematomas. J Trauma. 1982;22(6): Submit your next manuscript to BioMed Central and we will help you at every step: We accept pre-submission inquiries Our selector tool helps you to find the most relevant journal We provide round the clock customer support Convenient online submission Thorough peer review Inclusion in PubMed and all major indexing services Maximum visibility for your research Submit your manuscript at
Intraoperative contralateral extradural hematoma during evacuation of traumatic acute extradural hematoma: A case report with review of literature
Intraoperative contralateral extradural hematoma during evacuation of traumatic acute extradural hematoma: A case report with review of literature Anand Sharma 1, Arti Sharma 2, Yashbir Dewan 1 1 Artemis
More informationOnly 30% to 40% of acute subdural hematoma (SDH)
Contralateral Acute Epidural Hematoma After Decompressive Surgery of Acute Subdural Hematoma: Clinical Features and Outcome Thung-Ming Su, MD, Tsung-Han Lee, MD, Wu-Fu Chen, MD, Tao-Chen Lee, MD, and Ching-Hsiao
More informationIntroduction. Materials and Methods. Young Hwan Choi, Tea Kyoo Lim, and Sang Gu Lee. 108 Copyright 2017 Korean Neurotraumatology Society
CLINICAL ARTICLE Korean J Neurotrauma 2017;13(2):108-112 pissn 2234-8999 / eissn 2288-2243 https://doi.org/10.13004/kjnt.2017.13.2.108 Clinical Features and Outcomes of Bilateral Decompression Surgery
More informationSubdural hemorrhages in acute lymphoblastic leukemia: case report and literature review
Yin et al. Chinese Neurosurgical Journal (2016) 2:25 DOI 10.1186/s41016-016-0045-4 CHINESE NEUROSURGICAL SOCIETY CASE REPORT CHINESE MEDICAL ASSOCIATION Subdural hemorrhages in acute lymphoblastic leukemia:
More informationPOSTOPERATIVE CHRONIC SUBDURAL HEMATOMA FOLLOWING CLIP- PING SURGERY
Nagoya postoperative Med. J., chronic subdural hematoma after aneurysmal clipping 13 POSTOPERATIVE CHRONIC SUBDURAL HEMATOMA FOLLOWING CLIP- PING SURGERY TAKAYUKI OHNO, M.D., YUSUKE NISHIKAWA, M.D., KIMINORI
More informationUSE OF NEAR INFRARED SPECTROSCOPY TO IDENTIFY TRAUMATIC INTRACRANIAL HEMATOMAS
JOURNAL OF BIOMEDICAL OPTICS 2(1), 31 41 (JANUARY 1997) USE OF NEAR INFRARED SPECTROSCOPY TO IDENTIFY TRAUMATIC INTRACRANIAL HEMATOMAS Claudia S. Robertson, Shankar P. Gopinath, and Britton Chance* Baylor
More informationExtradural hematoma (EDH) accounts for 2% of all head injuries (1). In
CASE REPORT Conservative management of extradural hematoma: A report of sixty-two cases A. Rahim H. Zwayed 1, Brandon Lucke-Wold 2 Zwayed ARH, Lucke-wold B. Conservative management of extradural hematoma:
More informationSurgical Management & Clinical Outcome of Severe Brain Trauma due to Acute Subdural Hematoma.
International Journal of Sciences: Basic and Applied Research (IJSBAR) ISSN 2307-4531 (Print & Online) http://gssrr.org/index.php?journal=journalofbasicandapplied ----------------------------------------------------------------------------------------------------------------
More informationAcute cerebral MCA ischemia with secondary severe head injury and acute intracerebral and subdural haematoma. Case report
214 Balasa et al - Acute cerebral MCA ischemia Acute cerebral MCA ischemia with secondary severe head injury and acute intracerebral and subdural haematoma. Case report D. Balasa 1, A. Tunas 1, I. Rusu
More informationClinical Outcome of Borderline Subdural Hematoma with 5-9 mm Thickness and/or Midline Shift 2-5 mm
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/300 Clinical Outcome of Borderline Subdural Hematoma with 5-9 mm Thickness and/or Midline Shift 2-5 mm Raja S Vignesh
More informationUpdate sulle lesioni emorragiche posttraumatiche
Update sulle lesioni emorragiche posttraumatiche Corrado Iaccarino Neurochirurgia-Neurotraumatologia AOU Parma Neurochirurgia d'urgenza IRCCS ASMN Reggio Emilia LAW UPDATING This document provides recommendations
More informationRisk Factors Related to Hospital Mortality in Kenyan Patients with Traumatic Intracranial Haematomas
Risk Factors Related to Hospital Mortality in Kenyan Patients with Traumatic Intracranial Haematomas K.P. Kithikii 1, K.J. Githinji 2 1 Department of Human Anatomy, University of Nairobi, Kenya 2Consultant,
More informationMoron General Hospital Ciego de Avila Cuba. Department of Neurological Surgery
Moron General Hospital Ciego de Avila Cuba Department of Neurological Surgery Early decompressive craniectomy in severe head injury with intracranial hypertension Angel J. Lacerda MD PhD, Daisy Abreu MD,
More informationCorrespondence should be addressed to Sorayouth Chumnanvej;
Neurology Research International Volume 2016, Article ID 2737028, 7 pages http://dx.doi.org/10.1155/2016/2737028 Research Article Assessment and Predicting Factors of Repeated Brain Computed Tomography
More informationOutcome Evaluation of Chronic Subdural Hematoma Using Glasgow Outcome Score
Outcome Evaluation of Chronic Subdural Hematoma Using Glasgow Outcome Score Mehdi Abouzari, Marjan Asadollahi, Hamideh Aleali Amir-Alam Hospital, Medical Sciences/University of Tehran, Tehran, Iran Introduction
More informationConcomitant Traumatic Spinal Subdural Hematoma and Hemorrhage from Intracranial Arachnoid Cyst Following Minor Injury
Chin J Radiol 2005; 30: 173-177 173 Concomitant Traumatic Spinal Subdural Hematoma and Hemorrhage from Intracranial Arachnoid Cyst Following Minor Injury HUI-YI CHEN 1 YING-SHYUAN LI 1 CHUNG-HO CHEN 1
More informationGiant schwannoma with extensive scalloping of the lumbar vertebral body treated with one-stage posterior surgery: a case report
Iizuka et al. Journal of Medical Case Reports 2014, 8:421 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Giant schwannoma with extensive scalloping of the lumbar vertebral body treated with one-stage
More informationAcute Clinical Deterioration of Posterior Fossa Epidural Hematoma: Clinical Features, Risk Factors and Outcome
Original Article 271 Acute Clinical Deterioration of Posterior Fossa Epidural Hematoma: Clinical Features, Risk Factors and Outcome Tsung-Ming Su, MD; Tsung-Han Lee, MD; Tao-Chen Lee, MD; Ching-Hsiao Cheng,
More informationCase Report Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood
Case Reports in Medicine Volume 2013, Article ID 956849, 4 pages http://dx.doi.org/10.1155/2013/956849 Case Report Spontaneous Rapid Resolution of Acute Epidural Hematoma in Childhood Ismail GülGen, 1
More informationBrain Injuries. Presented By Dr. Said Said Elshama
Brain Injuries Presented By Dr. Said Said Elshama Types of head injuries 1- Scalp injuries 2- Skull injuries 3- Intra Cranial injuries ( Brain ) Anatomical structure of meninges Intra- Cranial Injuries
More informationAnton-Babinski syndrome as a rare complication of chronic bilateral subdural hematomas
DOI: 10.2478/romneu-2018-0050 Article Anton-Babinski syndrome as a rare complication of chronic bilateral subdural hematomas D. Adam, D. Iftimie, Cristiana Moisescu, Gina Burduşa ROMANIA Romanian Neurosurgery
More informationTo date, head injury remains the leading cause of. Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation
J Neurosurg 111:683 687, 2009 Outcome in patients with blunt head trauma and a Glasgow Coma Scale score of 3 at presentation Clinical article Ro u k o z B. Ch a m o u n, M.D., Cl a u d i a S. Ro b e r
More informationA Comprehensive Study on Post Traumatic Temporal Contusion in Adults
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/318 A Comprehensive Study on Post Traumatic Temporal Contusion in Adults R Renganathan 1, P John Paul 2, Heber Anandan
More informationPediatric Subdural Hematoma and Traumatic Brain Injury J. Charles Mace MD FACS Springfield Neurological Institute CoxHealth. Objectives 11/7/2017
Pediatric Subdural Hematoma and Traumatic Brain Injury J. Charles Mace MD FACS Springfield Neurological Institute CoxHealth Objectives 1. Be able to discuss brain anatomy and physiology as it applies to
More informationEvaluation of Craniocerebral Trauma Using Computed Tomography
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 13, Issue 9 Ver. IV (Sep. 2014), PP 57-62 Evaluation of Craniocerebral Trauma Using Computed Tomography
More informationIs Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?
www.jkns.or.kr http://dx.doi.org/10.3340/jkns.2015.58.2.125 J Korean Neurosurg Soc 58 (2) : 125-130, 2015 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2015 The Korean Neurosurgical Society Clinical
More informationTraumatic Brain Injury Pathway, GCS 15 Closed head injury
Traumatic Brain Injury Pathway, GCS 15 Closed head injury Plus Any One of the Following Mild TBI 2010 Consensus Definition of TBI from CDC, NINDS, NIDDR, VA, DVBIC, DCoE Plus Any One of the Following New
More informationEfficacy of Decompressive Craniectomy in Acute Subdural Hematoma in Head Injury Patients, Madurai Medical College, Madurai
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/107 Efficacy of Decompressive Craniectomy in Acute Subdural Hematoma in Head Injury Patients, Madurai Medical College,
More informationBone flap preservation in abdominal wall after decompressive craniectomy in head injury: A single institute experience
DOI: 10.2478/romneu-2018-0063 Article Bone flap preservation in abdominal wall after decompressive craniectomy in head injury: A single institute experience Pavan Kumar, Ashok Kumar, Gaurav Jaiswal, Tarun
More informationA rare complication of chronic subdural hematoma evacuation: brain stem hemorrhage: a case report
DOI: 10.2478/romneu-2018-0057 Article A rare complication of chronic subdural hematoma evacuation: brain stem hemorrhage: a case report Ghassen Gader, Mouna Rkhami, Maher Ben Salem, Mohamed Badri, Kamel
More informationAngel J. Lacerda MD PhD, Daisy Abreu MD, Julio A. Díaz MD, Sandro Perez MD, Julio C Martin MD, Daiyan Martin MD.
Angel J. Lacerda MD PhD, Daisy Abreu MD, Julio A. Díaz MD, Sandro Perez MD, Julio C Martin MD, Daiyan Martin MD. Introduction: Spontaneous intracerebral haemorrhage (SICH) represents one of the most severe
More informationMoyamoya Syndrome with contra lateral DACA aneurysm: First Case report with review of literature
Romanian Neurosurgery Volume XXXI Number 3 2017 July-September Article Moyamoya Syndrome with contra lateral DACA aneurysm: First Case report with review of literature Ashish Kumar Dwivedi, Pradeep Kumar,
More informationCT findings in patients with Cabazitaxel induced pelvic pain and haematuria: a case series
Malalagama et al. Cancer Imaging (2017) 17:17 DOI 10.1186/s40644-017-0119-3 CASE SERIES CT findings in patients with Cabazitaxel induced pelvic pain and haematuria: a case series Geethal N. Malalagama
More informationTraumatic Brain Injury Pathways for Adult ED Patients Being Admitted to Trauma Service
tic Brain Injury Pathways for Adult ED Patients Being Admitted to Service Revision Team Tyler W. Barrett, MD, MSCI Elizabeth S. Compton, NP Bradley M. Dennis, MD Oscar D. Guillamondegui, MD, MPH Michael
More informationCorrelation of Computed Tomography findings with Glassgow Coma Scale in patients with acute traumatic brain injury
Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-2 ABSTRACT OBJECTIVE To correlate Computed Tomography (CT) findings with Glasgow Coma Scale (GCS) in patients with acute traumatic brain injury
More informationA Guide to the Radiologic Evaluation of Extra-Axial Hemorrhage
July 2013 A Guide to the Radiologic Evaluation of Extra-Axial Hemorrhage John Dickson, Harvard Medical School Year III Agenda 1. Define extra-axial hemorrhage and introduce its subtypes 2. Review coup
More informationManagement Strategies for Communited Fractures of Frontal Skull Base: An Institutional Experience
80 Original Article THIEME Management Strategies for Communited Fractures of Frontal Skull Base: An Institutional Experience V. Velho 1 Hrushikesh U. Kharosekar 1 Jasmeet S. Thukral 1 Shonali Valsangkar
More informationDecompressive craniectomy following traumatic brain injury
Decompressive craniectomy following traumatic brain injury Peter Hutchinson Division of Academic Neurosurgery University of Cambridge Escalating cycle of brain swelling Primary insult Brain swelling Secondary
More informationEfficacy of neuroendoscopic evacuation of traumatic intracerebral or intracerebellar hematoma
Original Contribution Kitasato Med J 2017; 47: 141-147 Efficacy of neuroendoscopic evacuation of traumatic intracerebral or intracerebellar hematoma Hiroyuki Koizumi, 1,2 Daisuke Yamamoto, 1 Yasushi Asari,
More informationOriginal Article Remote cerebellar hemorrhage after microsurgical clipping of intracranial aneurysms: diagnosis and treatment a review of 13 cases
Int J Clin Exp Med 2016;9(2):3681-3686 www.ijcem.com /ISSN:1940-5901/IJCEM0012155 Original Article Remote cerebellar hemorrhage after microsurgical clipping of intracranial aneurysms: diagnosis and treatment
More informationNEURORADIOLOGY DIL part 3
NEURORADIOLOGY DIL part 3 Bleeds and hemorrhages K. Agyem MD, G. Hall MD, D. Palathinkal MD, Alexandre Menard March/April 2015 OVERVIEW Introduction to Neuroimaging - DIL part 1 Basic Brain Anatomy - DIL
More informationPRACTICE GUIDELINE. DEFINITIONS: Mild head injury: Glasgow Coma Scale* (GCS) score Moderate head injury: GCS 9-12 Severe head injury: GCS 3-8
PRACTICE GUIDELINE Effective Date: 9-1-2012 Manual Reference: Deaconess Trauma Services TITLE: TRAUMATIC BRAIN INJURY GUIDELINE OBJECTIVE: To provide practice management guidelines for traumatic brain
More informationUnilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive esotropia
Kim and Lee BMC Ophthalmology (2017) 17:266 DOI 10.1186/s12886-017-0658-1 RESEARCH ARTICLE Open Access Unilateral lateral rectus muscle advancement surgery based on one-fourth of the angle of consecutive
More informationCase 1. Case 5/30/2013. Traumatic Brain Injury : Review, Update, and Controversies
Case 1 Traumatic Brain Injury : Review, Update, and Controversies Shirley I. Stiver MD, PhD 32 year old male s/p high speed MVA Difficult extrication Intubated at scene Case BP 75 systolic / palp GCS 3
More informationARTERIOVENOUS MALFORMATION OR CONTUSION : A DIAGNOSTIC DILEMMA. Yong Pei Yee, Ibrahim Lutfi Shuaib, Jafri Malin Abdullah*
Malaysian Journal of Medical Sciences, Vol. 8, No. 2, July 2001 (47-51) CASE REPORT ARTERIOVENOUS MALFORMATION OR CONTUSION : A DIAGNOSTIC DILEMMA Yong Pei Yee, Ibrahim Lutfi Shuaib, Jafri Malin Abdullah*
More informationRisk factors predicting operable intracranial hematomas in head injury
J Neurosarg 77:9-14, 1992 Risk factors predicting operable intracranial hematomas in head injury MICHAEL B. GUTMAN, M.D., PH.D., RICHARD J. MOULTON, M.D., F.R.C.S.(C), IRENE SULLIVAN, B.A., Dw.C.S., GILLIAN
More informationMarshall Scale for Head Trauma Mark C. Oswood, MD PhD Department of Radiology Hennepin County Medical Center, Minneapolis, MN
Marshall Scale for Head Trauma Mark C. Oswood, MD PhD Department of Radiology Hennepin County Medical Center, Minneapolis, MN History of Marshall scale Proposed by Marshall, et al in 1991 to classify head
More informationMR imaging as predictor of delayed posttraumatic cerebral hemorrhage
J Neurosurg 69:203-209, 1988 MR imaging as predictor of delayed posttraumatic cerebral hemorrhage TOKUTARO TANAKA, M.D., TSUNEO SAKAI, M.D., KENICHI UEMURA, M.D., ATSUSHI TERAMURA, M.D., ICHIRO FUJISHIMA,
More informationLOSS OF CONSCIOUSNESS & ASSESSMENT. Sheba Medical Center Acute Medicine Department MATTHEW WRIGHT
LOSS OF CONSCIOUSNESS & ASSESSMENT Sheba Medical Center Acute Medicine Department MATTHEW WRIGHT OUTLINE Causes Head Injury Clinical Features Complications Rapid Assessment Glasgow Coma Scale Classification
More informationBrain AVM with Accompanying Venous Aneurysm with Intracerebral and Intraventricular Hemorrhage
Cronicon OPEN ACCESS EC PAEDIATRICS Case Report Brain AVM with Accompanying Venous Aneurysm with Intracerebral and Intraventricular Hemorrhage Dimitrios Panagopoulos* Neurosurgical Department, University
More informationORIGINAL ARTICLE. Temporal Lobe Injury in Temporal Bone Fractures. imaging (MRI) to evaluate lesions of the temporal
ORIGINAL ARTICLE Temporal Lobe Injury in Temporal Bone Fractures Richard M. Jones, MD; Michael I. Rothman, MD; William C. Gray, MD; Gregg H. Zoarski, MD; Douglas E. Mattox, MD Objective: To determine the
More informationAcute Brown-Sequard syndrome following brachial plexus avulsion injury. A report of two cases
University of Malaya From the SelectedWorks of Mun Keong Kwan September, 2011 Acute Brown-Sequard syndrome following brachial plexus avulsion injury. A report of two cases Mun Keong Kwan Available at:
More informationTorsion bottle, a very simple, reliable, and cheap tool for a basic scoliosis screening
Romano and Mastrantonio Scoliosis and Spinal Disorders (2018) 13:4 DOI 10.1186/s13013-018-0150-6 RESEARCH Open Access Torsion bottle, a very simple, reliable, and cheap tool for a basic scoliosis screening
More informationAzygos anterior cerebral artery aneurysm with subarachnoid hemorrhage
Chowdhury et al. Neuroimmunol Neuroinflammation 2018;5:39 DOI: 10.20517/2347-8659.2018.37 Neuroimmunology and Neuroinflammation Letter to Editor Open ccess zygos anterior cerebral artery aneurysm with
More informationINTRACRANIAL PRESSURE -!!
INTRACRANIAL PRESSURE - Significance raised ICP main cause of death in severe head injury main cause of morbidity in moderate and mild head injury main target and prognostic indicator in the ITU setting
More informationTakashi Yagisawa 1,2*, Makiko Mieno 1,3, Norio Yoshimura 1,4, Kenji Yuzawa 1,5 and Shiro Takahara 1,6
Yagisawa et al. Renal Replacement Therapy (2016) 2:68 DOI 10.1186/s41100-016-0080-9 POSITION STATEMENT Current status of kidney transplantation in Japan in 2015: the data of the Kidney Transplant Registry
More informationAnalysis of pediatric head injury from falls
Neurosurg Focus 8 (1):Article 3, 2000 Analysis of pediatric head injury from falls K. ANTHONY KIM, MICHAEL Y. WANG, M.D., PAMELA M. GRIFFITH, R.N.C., SUSAN SUMMERS, R.N., AND MICHAEL L. LEVY, M.D. Division
More informationImportance of Hematoma Removal Ratio in Ruptured Middle Cerebral Artery Aneurysm Surgery with Intrasylvian Hematoma
Journal of Cerebrovascular and Endovascular Neurosurgery pissn 2234-8565, eissn 2287-3139, http://dx.doi.org/10.7461/jcen.2017.19.1.5 Original Article Importance of Hematoma Removal Ratio in Ruptured Middle
More informationCase Report Neuroendoscopic Removal of Acute Subdural Hematoma with Contusion: Advantages for Elderly Patients
Case Reports in Neurological Medicine Volume 2016, Article ID 2056190, 5 pages http://dx.doi.org/10.1155/2016/2056190 Case Report Neuroendoscopic Removal of Acute Subdural Hematoma with Contusion: Advantages
More informationINDEX&NEUROTRAUMA&(INCLUDING&SPINAL&CORD&INJURIES)&!!
1 INDEX&NEUROTRAUMA&(INCLUDING&SPINAL&CORD&INJURIES)& Prehospital,care,in,patients,with,severe,traumatic,brain,injury:,does,the,level,of,prehospital, care,influence,mortality?,...,3 Contralateral,extraaxial,hematomas,after,urgent,neurosurgery,of,a,mass,lesion,in,patients,
More informationPerioperative Management Of Extra-Ventricular Drains (EVD)
Perioperative Management Of Extra-Ventricular Drains (EVD) Dr. Vijay Tarnal MBBS, FRCA Clinical Assistant Professor Division of Neuroanesthesiology Division of Head & Neck Anesthesiology Michigan Medicine
More informationComplications of Spontaneous Intracranial Hypotension
Complications of Spontaneous Intracranial Hypotension Poster No.: C-0890 Congress: ECR 2015 Type: Authors: Keywords: DOI: Scientific Exhibit K. Endo, Y. Kubo, M. Ida; Tokyo/JP Hemorrhage, Embolism / Thrombosis,
More informationHEAD INJURY. Dept Neurosurgery
HEAD INJURY Dept Neurosurgery INTRODUCTION PATHOPHYSIOLOGY CLINICAL CLASSIFICATION MANAGEMENT - INVESTIGATIONS - TREATMENT INTRODUCTION Most head injuries are due to an impact between the head and another
More informationSurgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE
Surgical Care at the District Hospital 1 17 Orthopedic Techniques Key Points 2 17.1 Traction Use an appropriate method of traction to treat fractures of the extremities and cervical spine Apply extremity
More informationComparison of Burr Holes and Decompressive Craniotomy in the Surgical Treatment of Traumatic Acute Subdural Hematoma
Med. J. Cairo Univ., Vol. 83, No. 1, March: 259-266, 2015 www.medicaljournalofcairouniversity.net Comparison of Burr Holes and Decompressive Craniotomy in the Surgical Treatment of Traumatic Acute Subdural
More informationDuret hemorraghe caused by traumatic brain injury: what the radiologist should know.
Duret hemorraghe caused by traumatic brain injury: what the radiologist should know. Poster No.: C-1270 Congress: ECR 2012 Type: Educational Exhibit Authors: P. Dewachter 1, T. Vanderhasselt 1, K. De Smet
More informationBrief Clinical Report: Recognizing Subdural Hemorrhage in Older Adults
Research Brief Clinical Report: Recognizing Subdural Hemorrhage in Older Adults Mark T. Pfefer, RN, MS, DC *1 ; Richard Strunk MS, DC 2 Address: 1 Professor and Director of Research, Cleveland Chiropractic
More informationOriginal Article CT grouping and microsurgical treatment strategies of hypertensive cerebellar hemorrhage
Int J Clin Exp Med 2016;9(8):15921-15927 www.ijcem.com /ISSN:1940-5901/IJCEM0022273 Original Article CT grouping and microsurgical treatment strategies of hypertensive cerebellar hemorrhage Xielin Tang
More informationI N individuals who have sustained antenor polar brain injury, the differentiation
VOL. 122, No. 3 FRONTAL EPIDURAL HEMATOMA* THE ANGIOGRAPHIC DIAGNOSIS WITH A NEW FINDING By DAVID DEE, JR., M.D.,f MERLIN E. WOESNER, M.D., and ISAAC SANDERS, M.D. LOS ANGELES, CALIFORNIA I N individuals
More informationClassical CNS Disease Patterns
Classical CNS Disease Patterns Inflammatory Traumatic In response to the trauma of having his head bashed in GM would have experienced some of these features. NOT TWO LITTLE PEENY WEENY I CM LACERATIONS.
More informationControlled Decompression for the Treatment of Severe Head Injury: A Preliminary Study
Original Investigation Received: 05.03.2013 / Accepted: 08.06.2013 DOI: 10.5137/1019-5149.JTN.8135-13.1 for the Treatment of Severe Head Injury: A Preliminary Study Şiddetli Kafa Travmasının Tedavisinde
More informationHead CT Scan Interpretation: A Five-Step Approach to Seeing Inside the Head Lawrence B. Stack, MD
Head CT Scan Interpretation: A Five-Step Approach to Seeing Inside the Head Lawrence B. Stack, MD Five Step Approach 1. Adequate study 2. Bone windows 3. Ventricles 4. Quadrigeminal cistern 5. Parenchyma
More informationPROPOSAL FOR MULTI-INSTITUTIONAL IMPLEMENTATION OF THE BRAIN INJURY GUIDELINES
PROPOSAL FOR MULTI-INSTITUTIONAL IMPLEMENTATION OF THE BRAIN INJURY GUIDELINES INTRODUCTION: Traumatic Brain Injury (TBI) is an important clinical entity in acute care surgery without well-defined guidelines
More informationAcute contrecoup epidural hematoma that developed without skull fracture in two adults: two case reports
Andoh et al. Journal of Medical Case Reports (2018) 12:166 https://doi.org/10.1186/s13256-018-1676-1 CASE REPORT Open Access Acute contrecoup epidural hematoma that developed without skull fracture in
More informationStandardize comprehensive care of the patient with severe traumatic brain injury
Trauma Center Practice Management Guideline Iowa Methodist Medical Center Des Moines Management of Patients with Severe Traumatic Brain Injury (GCS < 9) ADULT Practice Management Guideline Contact: Trauma
More informationSURGICAL MANAGEMENT OF ACUTE EPIDURAL HEMATOMAS
CHAPTER 3 M. Ross Bullock, M.D., Ph.D. Virginia Commonwealth University Medical Center, Richmond, Virginia Randall Chesnut, M.D. University of Washington School of Medicine, Harborview Medical Center,
More informationLars Jacobsson 1,2,3* and Jan Lexell 1,3,4
Jacobsson and Lexell Health and Quality of Life Outcomes (2016) 14:10 DOI 10.1186/s12955-016-0405-y SHORT REPORT Open Access Life satisfaction after traumatic brain injury: comparison of ratings with the
More informationDoes serum CA125 have clinical value for follow-up monitoring of postoperative patients with epithelial ovarian cancer? Results of a 12-year study
Guo and Peng Journal of Ovarian Research (2017) 10:14 DOI 10.1186/s13048-017-0310-y RESEARCH Does serum CA125 have clinical value for follow-up monitoring of postoperative patients with epithelial ovarian
More informationThe Meaning of the Prognostic Factors in Ruptured Middle Cerebral Artery Aneurysm with Intracerebral Hemorrhage
www.jkns.or.kr J Korean Neurosurg Soc 52 : 80-84, 2012 http://dx.doi.org/10.3340/jkns.2012.52.2.80 Print ISSN 2005-3711 On-line ISSN 1598-7876 Copyright 2012 The Korean Neurosurgical Society Clinical Article
More informationApplication of three-dimensional angiography in elderly patients with meningioma
Application of three-dimensional angiography in elderly patients with meningioma Poster No.: C-0123 Congress: ECR 2012 Type: Scientific Paper Authors: X. Han, J. Chen, K. Shi; Haikou/CN Keywords: Neuroradiology
More informationTHE ROLE OF IMAGING IN DIAGNOSIS OF SUBDURAL HEMATOMA: REVIEW ARTICLE
THE ROLE OF IMAGING IN DIAGNOSIS OF SUBDURAL HEMATOMA: REVIEW ARTICLE * Dr. Sumendra Raj Pandey, Prof. Dr. Liu Pei WU, Dr. Sohan Kumar Sah, Dr. Lalu Yadav, Md. Sadam Husen Haque and Rajan KR. Chaurasiya
More informationOHSU Neurological Surgery Education. Neurosurgical Basics. Copyright Oregon Health & Science University Department of Neurological Surgery
OHSU Neurological Surgery Education Neurosurgical Basics Chapter 1 Basic Principles: Cranial Three-Point Head Fixation Proper and safe application of a three-point rigid cranial fixation device provides
More informationTraumatic Brain Injuries
Traumatic Brain Injuries Scott P. Sherry, MS, PA-C, FCCM Assistant Professor Department of Surgery Division of Trauma, Critical Care and Acute Care Surgery DISCLOSURES Nothing to disclose Discussion of
More informationFixed and dilated pupils after trauma, stroke, and previous intracranial surgery: management and outcome
J Neurol Neurosurg Psychiatry 2001;71:175 181 175 Department of Neurosurgery, University Clinic Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany H Clusmann C Schaller J Schramm Correspondence to: Dr
More informationThe significance of traumatic haematoma in the
Journal of Neurology, Neurosurgery, and Psychiatry 1986;49:29-34 The significance of traumatic haematoma in the region of the basal ganglia P MACPHERSON, E TEASDALE, S DHAKER, G ALLERDYCE, S GALBRAITH
More informationTBI are twice as common in males High potential for poor outcome Deaths occur at three points in time after injury
Head Injury Any trauma to (closed vs. open) Skull Scalp Brain Traumatic brain injury (TBI) High incidence Most common causes Falls Motor vehicle accidents Other causes Firearm- related injuries Assaults
More informationA Thirteen-Year-Old Boy with Undiagnosed Congenital Heart Disease Presented with Brain Abscess. Raafat Hammad Seroor Jadah, MBBCh, BAO (NUI), LRCP&SI*
Bahrain Medical Bulletin, Vol. 35, No. 3, September 2013 A Thirteen-Year-Old Boy with Undiagnosed Congenital Heart Disease Presented with Brain Abscess Raafat Hammad Seroor Jadah, MBBCh, BAO (NUI), LRCP&SI*
More informationIntroduction to Neurosurgical Subspecialties:
Introduction to Neurosurgical Subspecialties: Trauma and Critical Care Neurosurgery Brian L. Hoh, MD 1, Gregory J. Zipfel, MD 2 and Stacey Q. Wolfe, MD 3 1 University of Florida, 2 Washington University,
More information8/29/2011. Brain Injury Incidence: 200/100,000. Prehospital Brain Injury Mortality Incidence: 20/100,000
Traumatic Brain Injury Almario G. Jabson MD Section Of Neurosurgery Asian Hospital And Medical Center Brain Injury Incidence: 200/100,000 Prehospital Brain Injury Mortality Incidence: 20/100,000 Hospital
More informationDiagnosis and treatment of spontaneous intracranial hypotension due to cerebrospinal fluid leakage
DOI 10.1186/s40064-016-3775-z CASE STUDY Open Access Diagnosis and treatment of spontaneous intracranial hypotension due to cerebrospinal fluid leakage Yake Zheng 1, Yajun Lian 1*, Chuanjie Wu 1, Chen
More informationCerebro-vascular stroke
Cerebro-vascular stroke CT Terminology Hypodense lesion = lesion of lower density than the normal brain tissue Hyperdense lesion = lesion of higher density than normal brain tissue Isodense lesion = lesion
More informationCEREBRAL INFARCTION AS NEUROSURGICAL POST OPERATIVE COMPLICATION : SERIAL CASES
CEREBRAL INFARCTION AS NEUROSURGICAL POST OPERATIVE COMPLICATION : SERIAL CASES Oleh Ferry Wijanarko, dr, Sp BS DR Agus Turchan, dr, Sp BS BEDAH SARAF SOLO Secretariat : Neurosurgery Subdivision Dr Moewardi
More informationRole of Computerized Tomography as Prime Imaging Modality in the Evaluation of Traumatic Brain Injury
ORIGINAL ARTICLE Role of CT as Prime Imaging Modality 10.5005/jp-journals-10050-10067 in Evaluation of Traumatic Brain Injury Role of Computerized Tomography as Prime Imaging Modality in the Evaluation
More informationTraumatic brain injuries are caused by external mechanical forces such as: - Falls - Transport-related accidents - Assault
PP2231 Brain injury Cerebrum consists of frontal, parietal, occipital and temporal lobes Diencephalon consists of thalamus, hypothalamus Cerbellum Brain stem consists of midbrain, pons, medulla Central
More informationDelayed Burr Hole Surgery in Patients with Acute Subdural Hematoma : Clinical Analysis
Clinical Article J Korean Neurosurg Soc 60 (6) : 717-722, 2017 https://doi.org/10.3340/jkns.2017.0404.010 pissn 2005-3711 eissn 1598-7876 Delayed Burr Hole Surgery in Patients with Acute Subdural Hematoma
More informationMidline shift in relation to thickness of traumatic acute subdural hematoma predicts mortality
Bartels et al. BMC Neurology (2015) 15:220 DOI 10.1186/s12883-015-0479-x RESEARCH ARTICLE Midline shift in relation to thickness of traumatic acute subdural hematoma predicts mortality Open Access Ronald
More informationUpper extremity open fractures in hospitalized road traffic accident patients: adult versus pediatric cases
Rubin et al. Journal of Orthopaedic Surgery and Research (2017) 12:157 DOI 10.1186/s13018-017-0657-1 RESEARCH ARTICLE Open Access Upper extremity in hospitalized road traffic accident : adult versus pediatric
More informationThe accuracy and precision of CT scan diagnosis in comparison with surgical findings in distinguishing epidertal hematoma from subdural hematoma
International Journal of Advanced Research in Biological Sciences ISSN: 348-80 www.ijarbs.com DOI: 10.19/ijarbs Coden: IJARQG(USA) Volume 4, Issue 8-017 Research Article DOI: http://dx.doi.org/10.19/ijarbs.017.04.08.009
More informationRisk Stratification in Patients with Severe Traumatic Acute Subdural Hematoma
eissn2465-891x The Nerve.2017.3(2):50-57 The Nerve https://doi.org/10.21129/nerve.2017.3.2.50 CLINICAL ARTICLE www.thenerve.net Risk Stratification in Patients with Severe Traumatic Acute Subdural Hematoma
More information